OBJECTIVE To study the protective effect and potential mechanism of chikusetsu saponin Ⅳ a （chsⅣ） on renal function in diabetic nephropathy （DN） model rats. METHODS DN rat model was established by high-fat diet combined with streptozotocin injection. Thirty-six model rats were randomly divided into model group （i.g. administration of normal saline， high-fat diet）， chsⅣ low-dose and high-dose groups （i.g. administration of 90， 180 mg/kg chsⅣ， high-fat diet）， with 12 rats in each group. Additionally， 10 normal rats were set as the control group （i.g. administration of normal saline， regular diet）. From the 5th to the 12th week after streptozotocin injection， they were given intragastric administration of relevant drug or normal saline， once a day. After the last medication， the levels of fasting blood glucose， fasting insulin， blood urea nitrogen， serum creatinine and urine protein as well as the levels of reduced glutathione （GSH）， superoxide dismutase （SOD） and malondialdehyde （MDA） in renal tissues were measured. Additionally， the insulin resistance index was calculated. Hematoxylin-eosin， periodic acid-Schiff， and Masson staining techniques were employed to examine the histopathological alterations in the renal tissue. The expressions of Notch signaling pathway-related proteins in renal tissue were detected by immunohistochemical staining and Western blot methods. RESULTS Compared with model group， the histomorphological of renal tissues in the chsⅣ low- and high-dose groups were significantly improved， with significant decreases in renal histological scores， mesangial expansion index， and glomerulosclerosis scores （ P ＜0.05）； the levels of fasting blood glucose， fasting insulin， blood urea nitrogen， serum creatinine， urine protein and homeostasis model assessment for insulin resistance， as well as MDA content， the expression levels of Notch1， Notch intracellular domain， hairy and enhancer of Split 1 and Delta-like protein 1 in renal tissue were all significantly decreased （ P ＜0.05）. The levels of GSH and SOD in renal tissue were significantly elevated （ P ＜0.05）. Moreover， the improvement in these indicators was significantly more pronounced in the chsⅣ high-dose group compared to the chsⅣ low-dose group （ P ＜0.05）. CONCLUSIONS ChsⅣ can ameliorate renal pathological damage and functional impairment in DN rats. Its underlying mechanisms include restoration of glucose homeostasis and insulin sensitivity， attenuation of renal oxidative stress， and suppression of aberrant Notch signaling pathway activation.

In modern society, people are increasingly exposed to chronic stress, leading to various mental disorders. However, the activities of brain regions, especially neural firing patterns related to specific behaviors, remain unclear. In this study, we introduce a novel approach, NeuroSync, which integrates open-field behavioral testing with electrophysiological recordings from emotion-related brain regions, specifically the central amygdala and the paraventricular nucleus of the hypothalamus, to explore the mechanisms of negative emotions induced by chronic stress in mice. By applying machine vision techniques, we quantified behaviors in the open field, and signal processing algorithms elucidated the neural underpinnings of the observed behaviors. Synchronizing behavioral and electrophysiological data revealed significant correlations between neural firing patterns and stress-related behaviors, providing insights into real-time brain activity underlying behavioral responses. This research combines deep learning and machine learning to synchronize high-resolution video and electrophysiological data, offering new insights into neural-behavioral dynamics under chronic stress conditions.
Animals ; Mice ; Male ; Emotions/physiology* ; Stress, Psychological/physiopathology* ; Action Potentials/physiology* ; Mice, Inbred C57BL ; Behavior, Animal/physiology* ; Machine Learning ; Amygdala/physiopathology* ; Neurons/physiology* ; Paraventricular Hypothalamic Nucleus/physiopathology* ; Brain/physiology*

Objectives:To evaluate the predictive value of Tabular Prior-data Fitted Network(TabPFN) for short-term outcome in patients with spontaneous intracerebral hemorrhage (sICH), and compared with the Extreme Gradient Boosting (XGboost) model and traditional logistic regression (LR) model. Methods:Patients with sICH admitted to the Department of Neurology, Hefei Second People's Hospital from January 2018 to March 2024 were included retrospectively. The demographic and baseline data were collected. At 3 months after onset, the modified Rankin Scale score was used to determine the outcome, 0-2 was defined as good outcome and >2 was defined as poor outcome. All enrolled patients were randomly divided into a training set and a testing set at a ratio of 7:3. Feature selection was performed using recursive feature elimination (RFE) method, and then the selected feature variables were included into TabPFN, XGboost, and LR models for training and testing. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the models. Shapley additive explanations (SHAP) method was used for model interpretation.Results:A total of 547 patients with sICH were enrolled, including 367 males (67.1%), with a median age of 65 (interquartile range, 54-76) years. Two hundred twenty-six patients (41.3%) had poor outcome. Age, baseline blood pressure (systolic blood pressure, diastolic blood pressure), baseline laboratory tests (white blood cell count, red blood cell count, platelet count, neutrophil count, hemoglobin, fasting blood glucose, creatinine, uric acid, urea nitrogen, alanine aminotransferase, aspartate aminotransferase), hematoma rupture into the ventricle, island sign, baseline hematoma volume, and baseline National Institutes of Health Stroke Scale (NIHSS) score were selected as characteristic variables using RFE method. ROC curve analysis showed that the ROC AUC for TabPFN, Xgboost, and LR models predicting poor short-term outcome in the testing set were 0.918 (95% confidence interval [ CI] 0.870-0.966], 0.883 (95% CI 0.826-0.940), and 0.905 (95% CI 0.854-0.957), respectively. SHAP analysis showed that the top four important variables in the TabPFN model were baseline NIHSS score, baseline hematoma volume, baseline aspartate aminotransferase, and age. Conclusions:The TabPFN model is superior to the LR model and the XGBoost model in predicting poor outcome in patients with sICH. In the TabPFN model, baseline NIHSS score, baseline hematoma volume, aspartate aminotransferase, and age are the most important predictors of poor outcome in patients with sICH.Objectives To evaluate the predictive value of Tabular Prior-data Fitted Network(TabPFN) for short-term outcome in patients with spontaneous intracerebral hemorrhage (sICH), and compared with the Extreme Gradient Boosting (XGboost) model and traditional logistic regression (LR) model. Methods Patients with sICH admitted to the Department of Neurology, Hefei Second People's Hospital from January 2018 to March 2024 were included retrospectively. The demographic and baseline data were collected. At 3 months after onset, the modified Rankin Scale score was used to determine the outcome, 0-2 was defined as good outcome and >2 was defined as poor outcome. All enrolled patients were randomly divided into a training set and a testing set at a ratio of 7:3. Feature selection was performed using recursive feature elimination (RFE) method, and then the selected feature variables were included into TabPFN, XGboost, and LR models for training and testing. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the models. Shapley additive explanations (SHAP) method was used for model interpretation. Results A total of 547 patients with sICH were enrolled, including 367 males (67.1%), with a median age of 65 (interquartile range, 54-76) years. Two hundred twenty-six patients (41.3%) had poor outcome. Age, baseline blood pressure (systolic blood pressure, diastolic blood pressure), baseline laboratory tests (white blood cell count, red blood cell count, platelet count, neutrophil count, hemoglobin, fasting blood glucose, creatinine, uric acid, urea nitrogen, alanine aminotransferase, aspartate aminotransferase), hematoma rupture into the ventricle, island sign, baseline hematoma volume, and baseline National Institutes of Health Stroke Scale (NIHSS) score were selected as characteristic variables using RFE method. ROC curve analysis showed that the ROC AUC for TabPFN, Xgboost, and LR models predicting poor short-term outcome in the testing set were 0.918 (95% confidence interval [ CI] 0.870-0.966], 0.883 (95% CI 0.826-0.940), and 0.905 (95% CI 0.854-0.957), respectively. SHAP analysis showed that the top four important variables in the TabPFN model were baseline NIHSS score, baseline hematoma volume, baseline aspartate aminotransferase, and age. Conclusions The TabPFN model is superior to the LR model and the XGBoost model in predicting poor outcome in patients with sICH. In the TabPFN model, baseline NIHSS score, baseline hematoma volume, aspartate aminotransferase, and age are the most important predictors of poor outcome in patients with sICH.

Large vessel occlusion due to intracranial atherosclerotic disease (ICAD-LVO) is one of the types of ischemic stroke with poor outcome. This article summarizes the relevant studies of ICAD-LVO in recent years, and reviews the imaging evaluation and treatment regimens to provide reference for clinical practice.

Objective:To investigate the current situation of water-borne endemic fluorosis in Anhui Province, and provide basic data for the adjusting the prevention and control measures.Methods:Using cross-sectional survey method, all villages in the water-borne endemic fluorosis areas were investigated in Anhui Province from 2019 to 2022. In water-borne endemic fluorosis village, the situation of water improvement project and the fluoride level of drinking water were investigated, and dental fluorosis of all children aged 8 - 12 was examined. The criteria for determining the achievement of control targets for water-borne endemic fluorosis in affected counties were based on the "Evaluation Measures for Control and Elimination of Key Endemic Diseases (2019 Edition)".Results:From 2019 to 2022, the rate of water improvement village in water-borne endemic fluorosis areas were 88.47% (1 527/1 726), 100% (1 726/1 726), 100% (1 726/1 726) and 100% (1 726/1 726), respectively. The qualified proportion of water fluoride in water-borne endemic fluorosis villages was 33.84% (584/1 726), 63.09% (1 089/1 726), 70.74% (1 221/1 726) and 74.33% (1 283/1 726), respectively. The prevalence rates of dental fluorosis in children aged 8 - 12 were 25.48% (45 461/178 440), 15.78% (27 959/177 200), 13.68% (23 505/171 880) and 12.66% (23 315/184 200), respectively. The proportion of affected counties that had achieved the control target of water-borne endemic fluorosis was 16% (4/25), 60% (15/25), 36% (9/25) and 40% (10/25), respectively.Conclusions:The water-borne endemic fluorosis areas in Anhui Province have improved the water fluoride qualification rate and reduced the incidence of fluorosis in children through prevention and control measures such as water improvement and fluoride reduction. However, the prevention and control efforts in key areas and counties need to be further improved.

This study characterized the whole-genome sequences of 45 Coxsackievirus A6(CVA6)strains isolated from Pudong District,Shanghai,during 2015-2023,to elucidate regional genetic evolution and recombination patterns.Viral genomes were ampli-fied and sequenced with Illumina MiSeq platforms,and phylogenetic analysis of the VP1 and 3D regions was conducted via MEGA 11(maximum-likelihood method,bootstrap=1 000).Nucleotide/amino acid homology and variation sites were assessed in DNAstar v7.0,and recombination events were identified with SimPlot v3.5.1 and RDP4.All isolates belonged to the D3a subtype,and exhibited intra-strain nucleotide and amino acid homologies of 88.0%-99.9%and 92.4%-100%,respectively,in contrast to lower homologies to the prototype Gdula strain(78.0%-80.5%nucleotide;94.5%-95.1%amino acid).Thirty-six mutation sites were identified in the VP1 re-gion.Recombination analysis revealed frequent cross-serotype events involving CVA4 and EV-A71,with dominant RF-A(84.5%)and minor RF-K(15.5%)patterns localized in the 3D region.This study elucidated the gene recombination and genetic evolution of CVA6 in Pudong District,Shanghai,thereby providing data support to enhance understanding of the evolutionary trends and genetic characteristics of coxsackieviruses,and offering theoretical evidence for the prevention and control of CVA6.

Objective:To explore the latent categories of nurses' perception of high-performance work systems (HPWS) through latent profile analysis and analyze the differences in characteristics and influencing factors among different categories.Methods:A convenience sampling method was used to select 3 450 clinical nurses from ClassⅡ、Ⅲ hospitals in 12 regions of China between June and July 2024. General information questionnaires, the Perceived High-Performance Work System Scale, and the Nurse Voice Behavior Scale were used for data collection. Latent profile analysis was conducted to analyze nurses' perception of HPWS, and multi-class logistic regression was used to examine the influencing factors for different categories.Results:A total of 3 450 questionnaires were collected, with 3 385 valid responses, yielding an effective response rate of 98.12%. Nurses' perception of HPWS had an average score of (70.46±12.21), which could be divided into three latent categories: low perception (17%, 559/3 385), moderate perception (42%, 1 433/3 385), and high perception (41%, 1 393/3 385). The multi-class logistic regression analysis showed that job nature, title, position, years of service, monthly income, health impact on work, work duration, and monthly night shifts were significant factors influencing nurses' perception of HPWS ( P<0.05) . Conclusions:There is heterogeneity in the nurses' perception of HPWS. Nursing managers should focus on nurses with low perception of HPWS and provide interventions and support based on the characteristics and influencing factors of each category to improve nurses' voice behaviors.

This study characterized the whole-genome sequences of 45 Coxsackievirus A6(CVA6)strains isolated from Pudong District,Shanghai,during 2015-2023,to elucidate regional genetic evolution and recombination patterns.Viral genomes were ampli-fied and sequenced with Illumina MiSeq platforms,and phylogenetic analysis of the VP1 and 3D regions was conducted via MEGA 11(maximum-likelihood method,bootstrap=1 000).Nucleotide/amino acid homology and variation sites were assessed in DNAstar v7.0,and recombination events were identified with SimPlot v3.5.1 and RDP4.All isolates belonged to the D3a subtype,and exhibited intra-strain nucleotide and amino acid homologies of 88.0%-99.9%and 92.4%-100%,respectively,in contrast to lower homologies to the prototype Gdula strain(78.0%-80.5%nucleotide;94.5%-95.1%amino acid).Thirty-six mutation sites were identified in the VP1 re-gion.Recombination analysis revealed frequent cross-serotype events involving CVA4 and EV-A71,with dominant RF-A(84.5%)and minor RF-K(15.5%)patterns localized in the 3D region.This study elucidated the gene recombination and genetic evolution of CVA6 in Pudong District,Shanghai,thereby providing data support to enhance understanding of the evolutionary trends and genetic characteristics of coxsackieviruses,and offering theoretical evidence for the prevention and control of CVA6.

Objective:To investigate the current situation of water-borne endemic fluorosis in Anhui Province, and provide basic data for the adjusting the prevention and control measures.Methods:Using cross-sectional survey method, all villages in the water-borne endemic fluorosis areas were investigated in Anhui Province from 2019 to 2022. In water-borne endemic fluorosis village, the situation of water improvement project and the fluoride level of drinking water were investigated, and dental fluorosis of all children aged 8 - 12 was examined. The criteria for determining the achievement of control targets for water-borne endemic fluorosis in affected counties were based on the "Evaluation Measures for Control and Elimination of Key Endemic Diseases (2019 Edition)".Results:From 2019 to 2022, the rate of water improvement village in water-borne endemic fluorosis areas were 88.47% (1 527/1 726), 100% (1 726/1 726), 100% (1 726/1 726) and 100% (1 726/1 726), respectively. The qualified proportion of water fluoride in water-borne endemic fluorosis villages was 33.84% (584/1 726), 63.09% (1 089/1 726), 70.74% (1 221/1 726) and 74.33% (1 283/1 726), respectively. The prevalence rates of dental fluorosis in children aged 8 - 12 were 25.48% (45 461/178 440), 15.78% (27 959/177 200), 13.68% (23 505/171 880) and 12.66% (23 315/184 200), respectively. The proportion of affected counties that had achieved the control target of water-borne endemic fluorosis was 16% (4/25), 60% (15/25), 36% (9/25) and 40% (10/25), respectively.Conclusions:The water-borne endemic fluorosis areas in Anhui Province have improved the water fluoride qualification rate and reduced the incidence of fluorosis in children through prevention and control measures such as water improvement and fluoride reduction. However, the prevention and control efforts in key areas and counties need to be further improved.

Objective:To explore the latent categories of nurses' perception of high-performance work systems (HPWS) through latent profile analysis and analyze the differences in characteristics and influencing factors among different categories.Methods:A convenience sampling method was used to select 3 450 clinical nurses from ClassⅡ、Ⅲ hospitals in 12 regions of China between June and July 2024. General information questionnaires, the Perceived High-Performance Work System Scale, and the Nurse Voice Behavior Scale were used for data collection. Latent profile analysis was conducted to analyze nurses' perception of HPWS, and multi-class logistic regression was used to examine the influencing factors for different categories.Results:A total of 3 450 questionnaires were collected, with 3 385 valid responses, yielding an effective response rate of 98.12%. Nurses' perception of HPWS had an average score of (70.46±12.21), which could be divided into three latent categories: low perception (17%, 559/3 385), moderate perception (42%, 1 433/3 385), and high perception (41%, 1 393/3 385). The multi-class logistic regression analysis showed that job nature, title, position, years of service, monthly income, health impact on work, work duration, and monthly night shifts were significant factors influencing nurses' perception of HPWS ( P<0.05) . Conclusions:There is heterogeneity in the nurses' perception of HPWS. Nursing managers should focus on nurses with low perception of HPWS and provide interventions and support based on the characteristics and influencing factors of each category to improve nurses' voice behaviors.